Pregnancy deaths more common in black women

NEW YORK (Reuters Health) - African-American women are no more likely than white women to develop pregnancy complications, but when they do, they are more likely to die, a U.S. government study shows.

Women in developed countries, regardless of race, have a low risk of dying during pregnancy or childbirth. However, research in the U.S. has shown that the odds are greater for black women than for white women.

It's been unclear whether this is because black women suffer pregnancy complications more often or because they have a higher risk of dying from them.

The new study found that between 1988 and 1999, the occurrence of common pregnancy complications in the U.S was the same for black and white women. Despite that, black women were two to three times more likely to die of the conditions.

Dr. Myra J. Tucker and colleagues at the U.S. Centers for Disease Control and Prevention base their findings on federal statistics gathered from hospital discharge records and other sources, and report the results in the American Journal of Public Health.

Overall, the study found, black and white women had similar rates of five of the most common pregnancy complications: pre-eclampsia, whose signs include elevated blood pressure and fluid retention; eclampsia, a more severe form of the disorder that can cause seizures or coma; placental abruption, in which the placenta separates from the uterine wall; placenta previa, in which the placenta blocks the opening to the birth canal; and hemorrhaging after childbirth.

By contrast, for every 100,000 women who developed pre-eclampsia, for example, roughly 27 white women died, versus 73 black women; and for every 100,000 cases of postpartum hemorrhage, 21 white women died compared with 68 black women.

The study lacked other information about the women's health and background, so the reasons for the disparities in death rates remain unclear.

According to Tucker and her colleagues, both general health and access to quality healthcare could play a role. African-American women are, for instance, less likely to have early, consistent and high-quality prenatal care than white women, the researchers note.

Black women are also more likely to have certain health conditions that can make pregnancy complications more dangerous, such as high blood pressure, diabetes and obesity.

To figure out why there's a racial disparity in pregnancy-related deaths, Tucker's team concludes, "a complex interaction of biological and health services factors must be untangled."

SOURCE: American Journal of Public Health, February 2007.